In addition to having individual therapy, it may be useful to seek out some form of group support. The thought of this can be absolutely appalling for most sex addicts. The out-of-control behaviours have generally been kept secret and are often shrouded in shame. The idea that they might now opening be discussed in a group of strangers can be hard to contemplate. Many clients I have worked with refuse point-blank to consider any form of group work when I suggest it at the beginning of therapy. However, when at a later stage they accept the need for it, they usually find it immensely supportive.
Group work is an important part of recovery for a number of reasons. Firstly, it provides an environment in which you can discuss your struggles with other people who have been experiencing similar things. This means they often have an innate understanding of what you are going through. Some of them may be ahead of you in the journey and can offer you support when you are struggling. You may later be able to do the same for others who may be just starting out.
Groups often provide an ongoing support that can fill the gaps between weekly therapy sessions. You will be able to reach out to other group members to talk about any triggers or desires to act out that that you are experiencing in between sessions.
Addiction robs people of meaningful relationships. Most addicts will agree that their most significant relationship has been with their addictive substance or behaviour, rather than with the people around them. Their craving for the next high prevents them from having real intimacy with others, as it means they will let people down, lie to them and hide things from them. It is impossible to have a close, intimate relationship with your wife, if you are concealing the fact that you visit escorts every week, chat to other women on hook-up apps and have spent a large portion of the family savings on your addiction. You have learnt to hides large parts of yourself in relationships and partners often describe their addict spouses as ‘strangers’ when they find out about their behaviours.
Often, individuals who struggle with compulsive behaviours come from families in which intimacy has been difficult. Perhaps feelings were not discussed, or even not allowed, when you were a child. Perhaps it wasn’t emotionally safe to get close to your parents because they would let you down or harm you. If you have not learnt how to have close, intimate relationships as a child, it is no wonder that it is a struggle for you as an adult.
For all these reasons, group work can provide a new experience that allows you to be seen and accepted for who you are, warts and all. It provides an opportunity for you to risk talking about your innermost thoughts, feelings and desires, without judgement, as those you are speaking to have very similar experiences. Gradually, through active engagement in a group, you will become more comfortable with intimacy and allow people in the outside world to get closer to you too. I imagine this may sound like a terrifying prospect for some of you reading this book, but at the same time it can be a rewarding and enriching experience.
There was a number of possibilities for engaging in group work. There are some very good organisations that run regular group programmes for individuals in recovery from compulsive sexual behaviour. Groups combine elements of teaching about sex addiction with experiential exercises to understand and address the causes of your own difficulties. They will provide you with practical tools to address potential slips and relapses. Some of these groups are intensive programmes, which involve a week of group activities in a residential setting. Others take place once a week over a longer period. Both of these types of work have great benefit. The intensive programmes can be very good, particularly at the beginning of recovery, when they offer the possibility of drawing a line and completely resetting your way of living. They give you an insight into your behaviours that can help you to continue with recovery after the course ends. The weekly programme offer an ongoing support that means that you can bring problems and difficulties to the group as they arise. You also have longer to absorb any insights and apply them to your daily lives in between sessions.
If you are in the UK, the group programmes run by both The Laurel Centre and The Marylebone Centre are of an excellent quality. They both run intensive and weekly courses. In the US, there are a wide range of groups, details of which can be obtained through the AASAT website.
Twelve Step Meetings
Another option that may people in recovery find helpful is attendance at Twelve Step meetings. Most of us are familiar with the Twelve Step organisation, Alcoholics Anonymous. However, we may not be aware that Twelve Step groups also exist for people in recovery from a range of other addictions, from drugs, to gambling, overeating and compulsive sexual behaviours.
Twelve Step programme follow a set framework, guiding people through a tried and tested process of recovery from addiction. The models used by all groups stem from the one developed by the founders of Alcoholics Anonymous. This, as the name suggests is based upon 12 steps that members work their way through as they enter recovery. The first step involves acknowledging that you are powerless against the sexual addiction and that your life has become unmanageable. Subsequent steps include taking a ‘moral inventory’ of yourself and acknowledging your character defects, and making amends to those you have hurt as a result of you out-of-control behaviours.
The programme gives people the opportunity to find a sponsor, who is generally someone who is further along in the recovery process and can act as a mentor and assist you in working through the twelve steps. It is important to remember that this person is not a therapist and will be dealing with their own struggles in the same areas that you are. Meetings also offer the possibility for outreach calls; by exchanging numbers with other members, you have the opportunity to call someone when you are feeling triggered, rather than immediately acting out. You can also provide support to someone else who is being triggered.
There are four Twelve Step programmes that provide support to individuals struggling with out-of-control sexual behaviour. These are Sex Addicts Anonymous (SAA), Sex and Love Addicts Anonymous (SLAA), Sexually Compulsives Anonymous (SCA) and Sexaholics Anonymous (SA). They all operate similarly in following the Twelve Step model, but each has a slightly different focus.
SAA focuses specifically on sex addiction. Most groups are mixed, but tend to be attended by more men than women. SAA run a number of single sex groups, which can be very useful for heterosexual men who would benefit from an environment in which they do not risk being triggered by the presence of women talking about their addictive behaviours.
SCA differs from SAA in its use of language, rejecting the term ‘sex addict’ in favour of ‘sexually compulsive’. This reflects the ongoing discussions as to whether it is correct to categorise out-pf-control behaviour as an addiction or a compulsive disorder. At the time of writing, SCA was mainly US based and did not have any meetings in the UK. It does have a meeting in Berlin.
SLAA describes itself as open to anyone struggling with sex addiction, love addiction, co-dependent relationships and sexual anorexia – amongst other things. Meetings can therefore include people looking to address quite a range of different problems. SLAA groups are often mixed. They include people suffering from love addiction (moving for one relationship to the next, seeking the highs of falling in love but struggling with the realities of long-term relationships). Love addiction seems to affect more women than men, hence the higher number of women attending SLAA than SAA, SCA or SA.
SA describes its aim as helping members to become ‘sexually sober’. Whereas the other organisations ask members to define what sobriety looks like for themselves, SA has a very strict definition of the term. They describe this, for the married person, as ‘having no form of sex with self or other persons, other than the spouse’. Many people may find this problematic, for instance, wanting to have the possibility to develop a healthy masturbation habit in the future. They define ‘spouse’ as ‘one’s partner in a marriage between a man and a woman’. For anyone who is unmarried – or by inference from their definition, anyone in a homosexual relationship - sexual sobriety means refraining from sex of any kind. Many people find this narrow view of healthy sexual relationships unhelpful and stigmatising of anyone who is not in a married, monogamous heterosexual relationship. SA meetings take place in a number of towns around the UK and are prevalent in the USA and other countries worldwide.
Your decision about group which to attend may partly be covered by geography. If you live in a big city like London, you will have a number of options, but if not, you may be limited. While attendance at a face-to-face meeting is likely to be the most supportive in terms of building up connection within the group, if this is not available to you, you can take advantage of one of the online meetings. All Twelve Step meetings are free of charge, which can be a big advantage if you are already investing in therapy. However, it is important to emphasise that they are not an alternative to therapy, but rather an adjunct. Groups are led by volunteers, not trained therapists. Everyone is working from a basis of their own personal experience, of addiction, recovery and working the Twelve Steps. They bring this wealth of experience into supporting others, and the value of this cannot be overestimated. However, they have no training in providing therapeutic support or dealing with trauma. It is therefore of utmost importance to be in one-to-one therapy, alongside group. You will find that you can often utilise therapy to explore issues that have arisen in group.
Couples' Therapy and Partner Therapy
In addition to seeking out therapeutic support for yourself, if you are in a relationship, you may be concerned for your partner. If they have recently discovered your compulsive behaviours, they may be suffering from shock and even trauma. In many cases, they may have nobody to confide in, feeling too ashamed to admit what they have discovered about the state of their relationship. There are many therapists who provide support to partners of people suffering from sexual addiction. They have undergone specific training that enables them to understand the partner’s experience and offer tailored help. Often, these are the same therapists who have specialist sex addiction training. It is important to note that your partner will not be able to see the same therapist as you, as there would be a conflict of interest.
Both The Laurel Centre and the Marylebone Centre run groups for partners. I have found that the networks developed during groups provide an excellent ongoing network to partners for years to come.
In addition to the Twelve Step groups available to individuals in recovery from out-of-control sexual behaviour, there is also a group for partners and others affected by someone’s behaviours. Many partners find COSA a very helpful arena, although it is based on a model that can identify a co-dependence in partners which has contributed to the addict’s behaviours (it’s former name was Co-Sex Addicts Anonymous). This is generally something that is rejected in sex addiction therapy today, and is seen as unhelpful.
You may also be wondering whether you should be in couples’ therapy. It is likely that the couple relationship has been severely harmed by the addiction and will need a great deal of support to mend. However, it is generally recommended that both people have individual therapy before any work starts on couples’ therapy. The addict needs individual support in stopping his behaviours and staying stopped, while the partner needs to heal her trauma and explore whether she wants to stay in the relationship.
Once both people have made significant progress in their own work – and, in general, I would recommend this lasts at least six months - they can enter couples’ therapy. This is likely to be with a third therapist, as the individual therapists will have formed deep therapeutic bonds with their clients, which will make it difficult to shift the focus on working with the couple.
If the full extent of the acting out behaviours has not been revealed or discussed in depth, a therapeutic disclosure may be necessary before the couple work can begin. This is a process whereby the partner prepares a list of questions for the person in recovery about their acting out behaviours. The person in recovery agrees to answer these honestly and openly. This can be an important step if the information about the behaviours has been provided in a ‘drip’ method, leaving the partner unsure whether they have all the facts.
Some couples find the Twelve Step group ‘Recovering Couples Anonymous’ (RCA) a very useful support structure, particularly if they have both participated in their own group programmes.
All of this information may seem overwhelming. It is clear that it would be possible to spend every waking moment outside of work involved in recovery groups, individual therapy and couples’ therapy! Some people do indeed immerse themselves in these activities as a way to avoid having any time available for acting out. What I find more useful is to achieve a balance between accessing the support you need and beginning to forge a new way of life that allows time for nurturing relationships, pursuing worthwhile and rewarding pass-times and building a fulfilling life. I have seen some clients use daily group attendance as a way of avoiding having to rebuild their lives with their partners and families. An addiction to group can replace the addiction to unhealthy sexual behaviours. In my experience, attending one to two group sessions a week, plus individual therapy, should be enough to support most individuals. If you find yourself using group to get out of spending time with your partner, or putting the children to bed, then you may need to look what it is that you are avoiding. It may be more comfortable to sit in a group of people who can empathise with your experiences and help you feel understood, than to face the difficult questions from your partner, which leave you feeling shamed. However, you will not be able to move your relationship forward until both of you have had the opportunity to move through the pain, reconnect and rebuild.